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Objective. Ulcerative colitis is a chronic inflammatory bowel disease, with multifactorial etiology, mainly determined by immunological and environmental factors. The purpose of this article is to describe an acute episode of ulcerative colitis, its management, and also the negative effects upon the fetus. Case. A 28-yearold secundiparous, at 34 weeks of gestation, presented to our clinic with acute mucous and bloody diarheea, cramping abdominal pain, being admitted with a diagnosis of preterm labour. Following sigmoidoscopy with biopsy and histopathological examination, a diagnosis of acute episode of ulcerative colitis was established, and a treatment with hydrocortisone, double antibiotic therapy and hydroelectrolytic repletion was administered, with initial favourable evolution. At 36 hours after admission, the patient's general status suddenly altered, and a magnetic resonance examination revealed toxic megacolon and acute fetal decompensation. The patient delivered through emergency caesarean section a live, hemodynamically and respiratory stable newborn. Conclusions. A multidisciplinary intervention is required in order to proper manage similar cases. The mother's and newborn's evolution was favourable under specific treatment. [ABSTRACT FROM AUTHOR]